What could be the reason for only one side bottoming out?

Dear Peanut44_,
bottoming out occurs when the implant falls below the current breast crease or inframammary line. It's more likely to happen with inframammary incisions, which is why I try not to use the inframammary approach to any breast surgery.
Bottoming out can also occur if an implant is too large for the breast pocket. That is why it is important to choose an implant size that's correct for your body. I perform numerous measurements in the office to determine optimal implant size for my patient's bodies.
If you are concerned, please check it with your plastic surgeon for reassurance and to further discuss your options and possibility of revision.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Unfortunately, you have not provided photographs or told us your bra size. However, at the time implants are placed, the support layer called fascia is often cut with the dual plane procedure. If the remaining fascia is too weak, it will tear and one side will bottom out. This is a result of gravity as well as pectoral major muscle movement. Larger implants creates more mechanical load and will increase the likelihood of bottoming out even more.

Best Wishes,

Gary Horndeski, M.D.

Do not go larger! Your tissue did not support the weight of the first implant and will not support a heavier implant. I would suggest going a little smaller for better long-term results. Your two breasts are not identical, nor do you use your arms the same.

Most people have significant a symmetry of their body.
This includes the breast left, typically sitting higher on the chest wall than the right side.
This is true for all people, both men and women.
From most people the left breast sits about half an inch higher than the right side.
For some people it’s slightly less.
If you look at your original before and after pictures, you’ll probably see that the left breast sits higher on your chest wall than the right side.
When surgeons do breast augmentation surgery, they often aiming towards creating symmetrical outcome, and this is often what patients want themselves.
If the left breast sits higher on the chest wall and the surgeon places the implants symmetrically, then they will place the implant lower than the left side.
The reason implants bottom out is because the IMF(infra mammary fold) has been opened or violated.
without including proper before, and after pictures, we can begin to make an assessment.
I am no idea what happened in your case, but my explanation seems plausible, considering that most people, including plastic surgeons are not aware that the left breast sits higher on the chest wall on almost every person in comparison to the right side.
take a look at pictures of naked people, and you’ll see that the left breast almost always sits higher than the right side.
if you want us to make an assessment regarding the outcome of your procedure, then try reposting with a complete set of proper before and after pictures.
if you want proper second opinion, consultation, and schedule that as an in person consultation with other plastic surgeons in your community.
For second opinion, consultations come prepared bringing with you a complete set of proper before and after pictures and copies of your previous operative report.
These are all part of your medical records and you can request them from your previous provider.
Best,
Mats Hagstrom MD